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Caregivers should balance self-care with the help they give others, crisis interventionist says

Anyone who cares for others might face 'compassion fatigue'

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September 07, 2023

Every job poses occupational hazards. Some are easily prevented, as when carpenters learn how to avoid smashing their thumbs with a hammer. Others are more complex and not as easily identified or overcome.

If not dealt with properly, such hazards can have lasting detrimental effects, according to a crisis interventionist who spoke to caregivers about compassion fatigue at the recent Summer Institute for Behavioral Health hosted by the Arizona State University School of Social Work.

Compassion fatigue affects individuals who work directly with trauma survivors. People such as nurses, case managers, supervisors, psychologists, social workers, therapists and first responders can suffer from potentially harmful effects of compassion fatigue, said Denise Beagley.

Beagley is the associate director of crisis and justice systems of complete care for Banner Health and has taught at the School of Social Work. She is also a crisis interventionist for the Chandler Fire Department. Her seminar was titled “Occupational Hazard: Overcoming Compassion Fatigue.”

Professor Charles Figley of Pennsylvania State University called compassion fatigue “the cost of caring.” In a 2006 book, “Compassion Fatigue in the Animal-Care Community,” Figley defined it as “the deep physical, emotional and spiritual exhaustion that can result from working day to day in an intense caregiving environment.”

“Working in this field, we cannot avoid being affected by the populations that we serve,” Beagley said. “But we can work at lessening the absorption of it.”

Compassion fatigue doesn’t only affect professionals. Beagley said a study she read reported that before the COVID-19 pandemic, 65 million Americans were caring for another person or persons.

Symptoms include hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, sleeplessness or nightmares, and a pervasive negative attitude, said Beagley, who teaches self-care techniques to neutralize compassion fatigue.

‘Get over it’ attitude can be harmful

Beagley has been teaching this topic for 11 years. She often uses the idea of a traffic signal to help caregivers identify where they are: green is feeling fulfilled, yellow is not so much, and red is feeling bad.

She said she’s found people in the compassionate professions generally feel positively about treating a close family member or friend who is suffering, but have negative thoughts about helping themselves deal with similar feelings — a sort of “get over it” attitude that can be harmful.

“In our job, part of it is to keep going, go on empty, and we expect things to change. But our fixes don’t work,” Beagley said. “How many times do you say, ‘I need a drink’ or ‘I need to call in sick’ because you’re so stressed out? We become consumed with our work even in our off-hours. We deny it, we stuff those things down into that five-gallon Home Depot bucket of bad stuff. You have to dump it out and fill it with good stuff.”

Sometimes professionals cope with trauma in unhealthy ways, such as with drugs or alcohol, she said.

“We don’t express our feelings because we think we’re the helpers and we shouldn’t need help,” Beagley said. “I walk them through that. I say what is draining my tank, then I ask them to say what’s draining theirs. Write it down. What are you excited about? Stressed about? If you can, how do you limit your access to negative effects?”

‘Find someone smarter’

Professional helpers need time to heal what Beagley called “emotional fractures,” just as they would treat a physical fracture.

“Unload your bucket in a safe place. Ask for help,” she said. “If you are the smartest person in the room, you’re in the wrong room. Find someone smarter. Don’t take more work on. It takes time to reverse it.”

Beagley said she once spoke to a police officer who experienced a traumatic incident but didn’t take leave afterward to deal with it.

“I asked him how he was coping, and he said he was drinking more, and you could almost see the light bulb go on,” she said.

In another instance, a firefighter approached Beagley and asked, “What is this stuff called compassion fatigue? I don’t think I have it.” She showed him a list of symptoms.

“He said, ‘I have every one of those symptoms.’”

Beagley advises caregivers to ask what’s out of balance in their lives to help them “stay in the green.”

“If you keep driving on a tire that’s out of balance, you could have a blowout,” she said. “Take inventory on your out-of-balance wheel.”

A few other tips for caregivers:

  • Practice positivity. Have a positive relationship with yourself.
  • Counter one negative thought with six positive thoughts.
  • Borrowing a phrase from Ted Lasso, the eponymous character of the recent Apple TV+ series: “Be 1% better than you were yesterday.”

The School of Social Work is part of the Watts College of Public Service and Community Solutions.

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